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Saturday 19 August 2017
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London nurses co-develop mobile app to tackle patient deterioration

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THEATRE AND SURGERY
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Nurses at Chelsea and Westminster Hospital NHS Foundation Trust have collaborated with physicians and IT services company ThinkShield to develop and roll-out a vital signs mobile app that could potentially save up to 60 lives per year through identifying and treating deteriorating patients earlier.  

Co-created by ThinkShield and the Chelsea and Westminster Hospitals NHS Foundation Trust, the app called ThinkVitals was initially launched across the hospital’s acute assessment unit and has now gone live across all adult wards at Chelsea and Westminster Hospital after extensive engagement with the nursing community.  

Around 400 nurses and healthcare assistantsare now inputting vital signs information, such as heart rate, blood pressure, temperature and respiratory rate, into the ThinkVitals app via hand held devices, replacingthe use of paper-based observation charts. The app generates approximately 61,000 transactions per day, almost two million per month. 

By moving to an IT patient based solution, the trust is benefitting from more accurate and up-to-date reporting. The app’s algorithms use Early Warning Scores and NICE guidelines to automatically calculate and identify patients most at risk, and who require prompt or urgent treatment. 

Information captured on mobile devices is also presented as a colour-coded ward view on large screens, displaying each patient’s location and condition allowing nurses and doctors to tell at-a-glance which patients need to be prioritised for clinical review.

Among the additional functionality suggested and developed by nurses was a fluid balance module which supports nurses and physicians to monitor patients’ input and output.

Dr Barry Quinn, Assistant Director of Nursing atthe trust said: “From a patient safety point-of-view we need to know constantly a patient’s vital signs and that their fluid balance is correct in order to direct care and treatment. Using ThinkVitals we now know that every hour of every day the vital signs and fluid balance is up-to-date.”

The trust’s ThinkVitals steering group actively invited and acted on regular feedback from clinical staff, embracing the principles of user-centered design outlined in the Wachter Reviewto increase usability and minimise disruption to current workflows.

Dr Quinn added: “Nurses are experts in caring for people and need support with the growing need for IT in the clinical setting. Nursing care is a combination of clinical and human skills, supported by IT solutions. Any IT system that is user friendly, is going to be much more attractive to nurses, and ThinkVitals is just that.”  

An internal survey by the trust revealed that 95% of nursing staff using the newly developed system who responded, found ThinkVitals easy to use and wanted to move even further towards IT clinical solutions for patients, highlighting the app’s popularity.

Dr Gary Davies, Clinical Director for Acute Services at the trust commented: “It’s almost unheard of in healthcare to get this kind of positive response on a user acceptance survey. It has been probably the easiest clinical IT project that I’ve ever been involved in. What’s helped is that the whole project design has had significant clinical input at all levels as well as the interface looking like the familiar previous paper observations forms. This has made it easy for nursing teams to adapt during the digitisation process”.

Eighty-four per cent of respondents welcomed the digitisition of all nursing documentation in the future to help reduce paper usage, improve confidentiality and security, reduce risk of losing observations charts, and improving communication across the ward teams. 

Tim Taylor, Managing Director of ThinkShield, added: “The demand at both national and local level to better support deteriorating patients in busy hospitals is clear to see. Our aim was to bring a very visual experience to nursing care, working closely with the frontline staff to make the application as highly intuitive and user-friendly as possible. This has helped minimise training especially during change over, and overall help to deliver a product for nurses’ everyday clinical needs.”

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